Vaginal McCall culdoplasty versus laparoscopic uterosacral plication to prophylactically address vaginal vault prolapse.

Background: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse.

Guideline for the management of postoperative nausea and vomiting.

Objective: To provide recommendations for the management of postoperative nausea and vomiting (PONV), which may affect as many as 30% of patients. METHODS AND EVIDENCE: Medline, PubMed, and the Cochrane Database were searched for articles published in English from 1995 to 2007. Recognizing that we must work as a team to optimize the care of our patients perioperatively, this guideline was written in partnership with anaesthesiologists.

Five year follow-up comparing tension-free vaginal tape and colposuspension.

Burch colposuspension has been the procedure of choice for stress urinary incontinence, more recently the tension-free vaginal tape (TVT) has been used. A retrospective study on all TVT's and colposupensions was performed. The present clinical condition was assessed using the Bristol Female Lower Urinary Tract Symptoms and Short-Form 12 questionnaires.

Vaginal hysterectomy: dispelling the myths.

Despite advances in minimally invasive surgery, most hysterectomies are still performed by laparotomy. The ratio of abdominal to vaginal hysterectomies ranges from 1:1 to 6:1 across North America, and in Canada is approximately 3:1. The SOGC clinical practice guideline on hysterectomy states that the vaginal route should be considered for every hysterectomy; if it is assumed that most surgeons would try to follow accepted guidelines, vaginal hysterectomy is presumably being considered and excluded.